tooth abscess -- diving?

[ksh]

Hi,

I have a question to the very famous Dr. Stein and /or anybody who might have had experience with a similar situation.

I have *new* (diagnosed last weeK) abscess under the tooth with *old* (7 years) crown. The tooth was a bit painfull at times after I did root canal and crown, but it would just get better on its own. (I've been diving for the 2 last years with no problems. ) Last week the gum started swelling really bad with heavy pain, so I went to the doctor (same one who did the old crown). He compared x-rays, and said that there's inflammation "between the roots" - he showed x-ray to me, and I saw between the roots something of different color that hadn't beed there on 7-year old x-rays.

He recommended cutting up abscess - which he did - and 5 days of antibiotic (clindamycin). I'm finishing antibiotic today, and pain is really gone, but the swelling is the same...

Now the question: I'm leaving for (what I planned will be) a week of diving off Grand Cayman on Saturday. My dentist has no idea about diving. I'm trying to understand - is there any specific dangers when diving with abscessed tooth? Anything I should look out for? Do or not do?

Sorry for the long post and Thanks!
Kathy

 

[Laurence Stein DDS]

Hi Kathy,

It sound like you have an inter-radicular abscess. This occurs between the roots of a tooth.

If I read your post correctly, you had both a crown and a root canal already performed...correct?

A recurrent abscess can have a variety of sources. Some root canals fail and the tooth has re-infected. Sometimes there is a fracture between the roots and even though there is a potentially successful root canal, a failure results from bacteria migrating through the fracture zone.

The swelling to the side of the tooth is most likely a fistula. That is an area draining the abscess. As long as there is an open fustula, there will be little, if any pain. The prognosis for this type of problem is uncertain.

Now, onto diving. The safest advice is to avoid diving till the infection and the fistula are gone. That being said, barodontalgia is rather rare. If the fistula remains, it is unlikely
that you will experience pain. If the fistula closes though, all bets are off.

Most dive vacations work according to Murphy's Law; Dive Vacation Corollary: You won't get an abscessed tooth until you are not only far from your own dentist, but also about 80 feet underwater and 2 hours from shore.

If you go, take an antibiotic and something for pain with you. Any sign of swelling, or pain in that tooth, STOP DIVING!

The prescriptions must be an a properly labeled Rx bottle with your name on it. If customs wants to make a fuss about medicine, you want it to be packaged properly. Coming BACK to the U.S. can be touchy if that "cute" little dog sniffs your stash

Ask your dentist for the medications. Don't take them unless you become symptomatic.

Be careful.

Laurence Stein, DDS
:doctor: Disclaimer
(No representations are made that in any way offer a diagnosis, treatment or cure for any illness or condition, either discussed or implied. Answers to questions are offered as information only and should always be used in conjunction with advice from your personal diving physician/dentist. I take no responsibility for any conceivable consequence, which might be related to any visit to this site.)

 

[ksh]

Thank you!

Yes, I did have both root canal and crown done 7 years ago. Well, I'll hope for the best and keep pills tidy

Kathy